• Title/Summary/Keyword: operating procedure

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Clinical Analysis on the Closed Thoracostomy -2341 cases (폐쇄식 흉강 삽관술에 대한 임상적 고찰)

  • Kim, Cheon-Seog;Kim, Yeun-Gue;Park, Jin;Lee, Kyong-Woon
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.991-1000
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    • 1997
  • Closed thoracostomy with UWSD* which is the most utilized procedure in chest surgery applies general thoracic disorders, trauma and after-thoracic surgery. The University hospital was involved on operating 2341 cases of closed thoracostomy with UWSD except chest tubing after-thoracic surgery for a full six years from January, 1991 to December, 1996. The rate of men and women out of the total 2341 cases was 3.5 : 1, the distribution by age showed that men were 36.6 $\pm21.0$ years old, women were $47.0\pm20.2$ years old and so that the total were 40.0 $\pm$ 20.5 years old. As for indication, spontaneous, secondary and traumatic pneumothorax were the most common, in addition to hemothorax hemopneumothorax, hydrothorax, hydropneumothorax, empyema, chylothorax. The most indwelling period of chest tubing is between eight and fourteen days for 974 cases and the average is 13.7 $\pm$ 6.3 days, The average drainage amount immediately after thoracostomy was 537 $\pm$ 88m1, and in 694 cases(46.0%), the drain amount was 201 ~ 500 ml. The rate of right and left tubing was 52.4 47.6, in 2071 cases(88.5%), the thoracostomy was the first chance and 2210 cases(94.4%) were treated with a single tube drainage. Almost all the patients complained of tube site pain, besides tube site infection, intercostal neuralgia, loss of tube function by the pleural adhesion, intrathoracic infection, incomplete reexpansion of defective lung, hemorrhage caused by the rupture of a blood vessel, subcutaneous emphysema, lung parenchymal rupture, diaphragmatic and intraabdominal trauma, reexpansionary pulmonary edema of one side lung and cellulitis were relapsed. 84.6% of all patients recovered with only clo ed thoracostomy and the rest of patient needed additional some necessary managements and so on to have successful results. There were two deaths(0.1%), caused by reexpansionary pulmonary edema, the cellulitis were complicated by thoracostomy with UWSD on an empyema patients to come to death(due to sepsis). t UWSD = under water seal drainage

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Aortic Valvuloplasty Using Leaflet Extension Technique (판막첨 연장술을 이용한 대동맥판막 성형술의 중기성적 평가)

  • Ahn, Hyuk;Kim, Hyun-jo
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.656-662
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    • 1997
  • Aortic valvuloplasty has recently gained attention as an attractive alternative procedure for aortic valvular disease. Between March 1995 to August 1996, 14 patients with pure aortic regurgitation(AR) underwent aortic alvuloplasty using leaflet extension with glutaraldehydepreserved autologous pericardium. There were 11 males and 3 females, and the mean age was 34.8 $\pm$ 15.3 years. Preoperative echocardiography and cardiac catheterization revealed that the degree of AR was mean 3.4$\pm$0.65, and more than moderate degree of mitral regurgitation(MR) were detected in 4 patients. In 12 patients, 3 leaflets were extended and in another 2 patients only one deformed leaflet was extended. Concomitant mitral valvuloplasty (MVP) was performed in 4 patients. The competency of the aortic valve after completion of repair was evaluated by the transesophageal echocardiography in operating theater, and there was no aortic and mitral stenosis or regurgitation. In an early postoperative echocardiography, trivial AR was detected in 3 patients and mild MR in 1 patient. The end-systolic and end-diastolic dimensions of the left ventricle were decreased significantly(p<0.05) as compared with those of preoperative values. T ere was no mortality and no significant postoperative complication encountered. Late complication developed in 2 patients during the follow-up period(mean 7.9$\pm$ 5.9 months). One patient underwent AVR on postoperative 7th month due to endocarditis, and the another patient with Behcet's disease underwent Ross operation at postoperative 4th month. In conclusion, AVP of leaflet extension technique offers an excellent early clinical result and represents a good alterna!ivy surgical treatment for the pure AR especially in young age group, although long-term follow-up is necessary to determine the durability of glutaraldehyde-preserved autologous pericardium as a valve leaflet.

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Physicochemical Changes of Swine Manure by the Treatment of Acid and Alkali for Inactivation of Pathogenic Microorganisms (병원성미생물의 불활성화를 위한 산·알칼리처리가 양돈분뇨의 이화학적 성상에 미치는 영향)

  • Kim, Cho-Long;Kim, Soo-Ryang;Kim, Ha-Je;Jeon, Sang-Joon;Han, Ho;Kim, Dong-Kyun;Lee, Myung-Gyu
    • Journal of Animal Environmental Science
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    • v.18 no.3
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    • pp.229-234
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    • 2012
  • Disinfecting contaminated swine manure with FMD (Foot-and-Mouth Disease) and pathogenic viruses is very important for maintaining sanitized environment. However, very few research reported on this subject, especially post-disinfection to utilize the wastes as a renewable resource. This research is carried out to obtain basic information for chemical treatment in FMD SOP (Standard Operating Procedure, Korea) of contaminated swine manure. Using lime, sodium hydroxide, citric acid and hydrochloric acid, described in FMD SOP, the effects of chemical treatments on livestock manure were compared in this paper. Four combinations of alkali-acid treatments and four kinds of acid-alkali combinations were tested to find out the effective method. Total coliform bacteria in contaminated swine manure, $1.6{\times}10^4$ CFU/100 ml, decreased to the range of 1/1000~1/100 in all treatments. Some specific disinfectants increases BOD (Biochemical Oxygen Demand) and EC(Electric Conductivity), especially, alkaline treatments increases ammonia level than acid treatments. These findings suggest that the treatment methods should be considered as an important environmental factor in post-disinfection of contaminated animal manure with pathogenic microorganisms.

Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

On decrease program of Radioactive Wastewater and Sewages in High Dose Radioiodine Therapy Ward (고용량 방사성옥소 치료병실의 오.폐수 저감화를 위한 연구)

  • Ryu, Jae-Kwang;Jung, Woo-Young;Shin, Sang-Ki;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.19-26
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    • 2008
  • Purpose: In general, We discharged radioactive wastewater and sewages less than $8.1{\times}10^{-13}$ Ci/ml in a exclusive water-purifier tank. Our hospital operating three exclusive water-purifier tank for radioactive wastewater and sewages of 60 tons capacity respectively. In order to meet the criteria it need a enough decay more than 125 days per each exclusive tank. However, recently we fell into the serious situation that decay period was decreased remarkably, owing to the wastewater amount increased rapidly by enlarge the therapy ward. For that reason, in this article, I'd like to say the way that reducing of radioactive wastewater and sewages rationally. Materials and Methods: From January, 2006 to October, four hundred and two cases were analyzed. They were all hospitalized during 3 days and 2 nights. We calculated the average amount of water used (include toilet water used, shower water used, washstand water used, $\cdots$), each exclusive water-purifier tank's decay period, as well as try to search the increased factors about water-purifier tank inflow flux by re-analysis of the procedure of radioisotope therapy step by step. Results: We could increase each exclusive water-purifier tank's decay period from 84 days to 130 days through the improvement about following cause: (1) Improvement of conventional toilet stool for excessive water waste $\rightarrow$ Replacement of water saving style toilet stool (2) Prevention of unnecessary shower and wash (3) Stop the diuretics taking during hospitalization (4) Analysis of relationship between water intakes and residual dose of body (5) Education about outside toilet utilization before the administration (6) Changed each water-purifier tank's maximum level from85% to 90% Conclusion: The originality of our efforts are not only software but hardware performance improvements. Incidentally the side of software's are change of therapy procedures and protocols, the side of hardware's are replacement of water saving style toilet stool and change of each water-purifier tank's maximum level. Thus even if a long lapse of time, problem such as return to the former conditions may not happen. Besides, We expect that our trials become a new reasonable model in similar situation.

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A Study on Network Hospital and the Ban on Opening and Operating the Muliple Medical Institution (네트워크병원과 의료기관 복수 개설·운영 금지 제도에 관한 고찰)

  • KIM, JOON RAE
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.281-313
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    • 2016
  • Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution and one of them is to prohibit the operation of multiple medical institutions In the past, there was a provision stipulating the same purpose. But because the Supreme Court interpreted that several medical institutions could be opened if the medical treatment was not made at the additional medical instition which was opened in the another doctor,s license, multiple medical institutions could be opened and operated. However, some health care providers opened the several medical institutions to another doctor's license just by the excuse of the business management and then did illegal medical cares like the unfair luring of patients, overtreatment, and commition treatment for more profits. So, the health rights of the people came to be infringed on. Accordingly, lawmakers amended the Medical Law for medical personnel not to open and to operate more than one medical institution. As the amended medical law prohibited a medical personnel to open multiple medical institution, some medical personnels insisted that the amended medical law is unconstitutional under which they could not be able to open and operate medical institutions on based on free investment and bring out the benefits of network hospitals. But the regulation to prohibit multiple institutions does not apply only to a medical personnel. Many other experts like lawyer and pharmacist can open only one office under such a restriction. If the regulation goes out of force, the procedure that multiple medical institutions should be opened and operated in the capacity as a medical corporation or a non-profit corporation does not have to be followed. And we should keep in mind that the permission for medical personels to open multiple medical institutions could lead virtually to commercial hospital. If in the nation with a very low rate of public medical service, If only a few medical personnels with capital own many medical institutions and operate commercially them, this could cause a falling-off in quality of medical service, ultimately infringe on the health rights and the life right of the people.

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Development and Application of Training Program for RI-Biomics Manpower through Analysis of Educational Demands (교육수요 분석을 통한 RI-Biomics 전문인력 양성 프로그램 개발 및 적용)

  • Shin, Woo-Ho;Park, Tai-Jin;Yeom, Yu-Sun
    • Journal of The Korean Association For Science Education
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    • v.35 no.1
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    • pp.159-167
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    • 2015
  • RI-Biomics is a promising radiation convergence technology that combines radiation with bio science as new growth power technology. Many developed countries are focusing active support and constant exertion to dominate the RI-Biomics market in advance. In order to achieve global leadership in the RI-Biomics field, we need more highly advanced technologies and professional manpower. In fact, we have less manpower compared to technology we currently hold. In this study, we established a basic infrastructure to train professional manpower in the RI-Biomics field by developing/operating optimum training program through expert interviews and survey. The developed program has four organized sections to understand overall procedure of RI-Biomics. To evaluate our training program, we performed test operations with eight students who have a major related to RI-Biomics for three weeks in KARA (Seoul) and KAERI (Jung-eup). In detail, radioisotope usage and safety management were conducted for one week as basic course, RI-Biomics application technology was conducted for two weeks as professional course. To verify performance results of training program, we conducted to journal research, daily reports, and survey on participants. The results show a high level of satisfaction with training programs and continuous intention of involvement in our program. We also need to develop an intensive course to train high-quality human resources and to operate training program continuously. This training program will be used as basic materials for the development of RI-Biomics curriculum for university. Hence, we will expect that our training program contributes in training a professional manpower and develop RI-Biomics technology.

A Methodology to Develop a Curriculum of Landscape Architecture based on National Competency Standards (국가직무능력표준(NCS) 기반 조경분야 교육과정 개발)

  • Byeon, Jae-Sang;Shin, Sang-Hyun;Ahn, Seong-Ro
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.2
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    • pp.23-39
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    • 2017
  • This study began from the question, "is there a way to efficiently apply industrial demand in the university curriculum?" Research focused on how to actively accept and respond to the era of the NCS (National Competency Standards). In order to apply NCS to individual departments of the university, industrial personnel must positively participate to form a practical-level curriculum by the NCS, which can be linked to the work and qualifications. A valid procedure for developing a curriculum based on the NCS of this study is as follows: First, the university must select a specific classification of NCS considering the relevant industry outlook, the speciality of professors in the university, the relationship with regional industries and the prospects for future employment, and the need for industrial manpower. Second, departments must establish a type of human resource that compromises goals for the university education and the missions of the chosen NCS. In this process, a unique competency unit of the university that can support the basic or applied subjects should be added to the task model. Third, the task model based on the NCS should be completed through the verification of each competency unit considering the acceptance or rejection in the curriculum. Fourth, subjects in response to each competency units within the task model should be developed while considering time and credits according to university regulations. After this, a clear subject description of how to operate and evaluate the contents of the curriculum should be created. Fifth, a roadmap for determining the period of operating subjects for each semester or year should be built. This roadmap will become a basis for the competency achievement frame to decide upon the adoption of a Process Evaluation Qualification System. In order for the NCS to be successfully established within the university, a consensus on the necessity of the NCS should be preceded by professors, students and staff members. Unlike a traditional curriculum by professors, the student-oriented NCS curriculum is needed sufficient understanding and empathy for the many sacrifices and commitment of the members of the university.

The Records and Archives Administrative Reform in China in 1930s (1930년대 중국 문서당안 행정개혁론의 이해)

  • Lee, Won-Kyu
    • The Korean Journal of Archival Studies
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    • no.10
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    • pp.276-322
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    • 2004
  • Historical interest in China in 1930s has been mostly focused on political characteristic of the National Government(國民政府) which was established by the KMT(中國國民黨) as a result of national unification. It is certain that China had a chance to construct a modern country by the establishment of the very unified revolutionary government. But, it was the time of expanding national crises that threatened the existence of the country such as the Manchurian Incident and the Chinese-Japanese War as well as the chaos of the domestic situation, too. So it has a good reason to examine the characteristic and pattern of the response of the political powers of those days. But, as shown in the recent studies, the manifestation method of political power by the revolutionary regime catches our attention through the understanding of internal operating system. Though this writing started from the fact that the Nationalist Government executed the administrative reform which aimed at "administrative efficiency" in the middle of 1930s, but it put stress on the seriousness of the problem and its solution rather than political background or results. "Committee on Administrative Efficiency(行政效率委員會)", the center of administrative reform movement which was established in 1934, examined the plan to execute the reform through legislation by the Executive Council(行政院) on the basis of the results of relevant studies. They claimed that the construction of a modern country should be performed by not political revolution anymore but by gradual improvement and daily reform, and that the operation of the government should become modern, scientific and efficient. There were many fields of administrative reform subjects, but especially, the field of records and archives adminstration(文書檔案行政) was studied intensively from the initial stage because that subject had already been discussed intensively. They recognized that records and archives were the basic tool of work performance and general activity but an inefficient field in spite of many input staff members, and most of all, archival reform bring about less conflicts than the fields of finance, organization and personnel. When it comes to the field of records adminstration, the key subjects that records should be written simply, the process of record treatment should be clear and the delay of that should be prevented were already presented in a records administrative meeting in 1922. That is, the unified law about record management was not established, so each government organization followed a conventional custom or performed independent improvement. It was through the other records administrative workshop of the Nationalist Government in 1933 when the new trend was appeared as the unified system improvement. They decided to unify the format of official records, to use marker and section, to unify the registration of receipt records and dispatch records and to strengthen the examination of records treatment. But, the method of records treatment was not unified yet, so the key point of records administrative reform was to establish a unified and standard record management system for preventing repetition by simplifying the treatment procedure and for intensive treatment by exclusive organizations. From the foundation of the Republic of China to 1930s, there was not big change in the field of archives administration, and archives management methods were prescribed differently even in the same section as well as same department. Therefore, the point at issue was to centralize scattered management systems that were performed in each section, to establish unified standard about filing and retention period allowance and to improve searching system through classification and proper number allowance. Especially, the problem was that each number system and classification system bring about different result due to dual operation of record registration and archives registration, and that strict management through mutual contrast, searching and application are impossible. Besides, various problems such as filing tools, arrangement method, preservation facilities & equipment, lending service and use method were raised also. In the process this study for the system improvement of records and archives management, they recognized that records and archives are the identical thing and reached to create a successive management method of records and archives called "Records and Archives Chain Management Method(文書檔案連鎖法)" as a potential alternative. Several principles that records and archives management should be performed unitedly in each organization by the general record recipient section and the general archives section under the principle of task centralization, a consistent classification system should be used by classification method decided in advance according to organizational constitution and work functions and an identical number system should be used in the process of record management stage and archive management stage by using a card-type register were established. Though, this "Records and Archives Chain Management Method" was developed to the stage of test application in several organizations, but it was not adopted as a regular system and discontinued. That was because the administrative reform of the Nationalist Government was discontinued by the outbreak of the Chinese-Japanese War. Even though the administrative reform in the middle of 1930s didn't produce practical results but merely an experimentation, it was verified that the reform against tradition and custom conducted by the Nationalist Government that aimed for the construction of a modern country was not only a field of politics, but on the other hand, the weak basis of the government operation became the obstacle to the realization of the political power of the revolutionary regime. Though the subject of records and archives administrative reform was postponed to the future, it should be understood that the consciousness of modern records and archives administration and overall studies began through this examination of administrative reform.

A Proposal on the Improvement of Obstacle Limitation Surface and Aeronautical Study Method (장애물 제한표면과 항공학적 검토방법의 제도 개선에 관한 제언)

  • Kim, Hui-Yang;Jeon, Jong-Jin;Yu, Gwang-Eui
    • The Korean Journal of Air & Space Law and Policy
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    • v.34 no.1
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    • pp.159-201
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    • 2019
  • Along with Annex 14 Volume I establishment in 1951 and the set-up of restriction surface around the runway, aeronautical technique and navigation performance achieved dazzling growth, and the safety and precision of navigation greatly improved. However, restrictions on surrounding obstacles are still valid for safe operation of an aircraft. Standards and criteria for securing safety of aircraft operating around and on airport is stated in Annex 11 Air Traffic Services and Annex 14 Aerodrome etc. In particular, Annex 14 Volume I presents the criteria for limiting obstacles around an airport, such as natural obstacles such as trees, mountains and hills to prevent collisions between aircraft and ground obstacles, and artificial obstacles such as buildings and structures. On the other hand, Annex 14 Volume I, in the application of the obstacles limitation surfaces, apply the exception criteria, as it may not be possible to remove obstacles that violate the criteria if the aeronautical study determines that they do not impair the safety and regularity of aircraft operation. Aeronautical study has been applied and implemented in various countries including United States, Canada and Europe etc. accordingly, Korea established and amended some provisions of the Enforcement rules of the Aviation Act and established the Aeronautical study guidelines to approve exceptions. However, because ICAO does not provide specific guidelines on procedures and methods of Aeronautical study, countries conducting aeronautical study have established and applied their own procedures and methods. Reflecting this realistic situation, at the 12th World Navigation Conference and at the 38th General Assembly, the contracting States demanded a reexamination of the criteria for current obstacle limitation surfaces and methods of aeronautical study, and the ICAO dedicated a team of experts to prepare new standard. This study, in line with the movement of international change in obstacle limitation surface and aeronautical study, aims to compare and analyze current domestic and external standards on obstacle limitation and height limits, while looking at methods, procedure and systems for aeronautical study. In addition, expecting that aeronautical study will be used realistically and universally in assessing the impact of obstacles, we would recommend the institutional improvement of the aeronautical study along with the development of quantitative analysis methods using the navigation data in the current aeronautical study.